Solving Integration and Workflows to Improve PediatricAsthma Care: A Propeller Health and Datica Collaboration
"Ultimately, we had to understand and implement the right HL7 messaging and workflow to correctly mirror the data models that the data flow required for parent/child. That’s where Datica has played a significant role in the process — knowing the nomenclature and the messaging that is HL7."Greg Tracy, Co-founder & CTO, Propeller Health
CASE IN FACT
Madison-based digital health company, Propeller Health, wants to empower patients and clinicians with new and better information to improve asthma and COPD care management. Prior to the company’s release of an automated solution for patients and clinicians, doctors would rely on patient recall as the best source of when and where symptoms occurred. In the best cases, patients used pen and paper to manually log symptoms in a daily diary, though this was often laden with inaccuracies and didn’t paint a complete picture of what might have caused an asthma attack. Real-time patient information didn’t exist. The result was that attacks could not be proactively managed and this would often lead to costly, and often unnecessary, visits to the emergency room.
Propeller has created a solution that provides transparency around the disease by connecting the care team through real-time analytics, while empowering patients in the process. Until this information is integrated into a hospital’s workflow, the EHR remains the barrier to a seamless stream of data in a modern primary care relationship.
After implementing the Propeller program with a west coast Children’s Hospital, Propeller was asked to integrate their respiratory information into the hospital’s regular EHR workflow.
Propeller Health CTO and co-founder Greg Tracy says, “I immediately thought of Datica because HL7 and EHR integration is not our core competency today. However, the opportunity with the Children’s Hospital gave us a great way to learn this integration piece and make it part of our standard offering.” With such a small development team, Propeller Health didn’t have the resources to siphon from its core work but felt it could easily partner with Datica on a project like this.
“The most complicated part of the project is the pediatric aspect of the hospital’s patient group, a dynamic that can be difficult to manage,” says Tracy. While the child carries around the sensor and is the one with the respiratory disease, it’s the parent who typically has the smartphone and is doing information monitoring; in that scenario, the parent becomes the caregiver. With Epic, the concept of account sharing and permissions does not exist.
“The challenge lies within Epic in that this patient/parent/caregiver workflow breaks the ID management setup within the EHR,” explains Tracy.
A COLLABORATIVE SOLUTION
To make the integration seamless, Datica worked with Propeller Health to combine the two accounts (patient and caregiver) on the vendor side. Next, the two accounts had to be presented as a single account to Epic to solve the patient/child login. To provide for this new caregiver login, the challenge required creative engineering. This is where the two companies spent the majority of their initial resources, energy, and time scoping the project. “Ultimately, we had to understand and implement the right HL7 messaging and workflow to correctly mirror the data models that the data flow required for parent/child. That’s the area that Datica has played a significant role in the process — knowing the nomenclature and the messaging that is HL7,” explains Tracy, who further adds that while Propeller Health could discuss the required resources, Datica Chief Data Officer Mark Olschesky can skillfully translate HL7 technologies.
Olschesky and his team built a workflow that helps to identify uncontrolled asthma patients who are most likely to benefit from Propeller’s solution. “The hospital built out decision support within their EMR to recommend Propeller’s devices to qualifying patients with asthma,” Olschesky says, further explaining that once patients are identified, the device is ordered along with the medication to treat their asthma.
This Propeller patient data flows back into the EMR so patients can view it in their patient portal account. Additionally, researchers can utilize the data with their existing tooling. “We had followed this workflow since Epic first implemented it with HealthKit and we’re excited to show what its utilization looks like with a standalone product like Propeller,” explains Olschesky.
To help hospitals and vendors achieve implementation goals, Olschesky says the company must help both parties work in the preferred language and data formats that they require. “When we talk about enrollment of patients and prescribing digital treatments, EHRs think of these workflows in terms of CPOE and HL7 messages. Most vendors think of workflows in terms of onboarding/data generated by their users, so we marry those terms together and provide a ‘rosetta stone’ between two different languages.”
For this project, Datica had to navigate through the nuances of pediatric workflows. While previously employed by Epic, Olschesky had fortunately spent two years working on both outpatient and inpatient clinical products at the Children’s Hospital in Dallas, where he quickly learned that in a pediatric environment, kids are not just little adults; they typically lack some important information in the EHR that adults automatically hold — an email address. “That valuable pediatric experience helped guide all parties toward a workflow that not only worked, but facilitated the research and patient engagement workflow needs,” says Olschesky.
To facilitate this Epic integration, a high level of engagement was required, including weeks spent developing the project scope. “That extended time isn’t typically found in more simple projects that involve ADT feeds, CCD queries, FHIR, etcetera,” explains Olschesky. Contributions from all key project stakeholders were invaluable in the effort, including:
The hospital client
- providing expertise regarding the functionality of their system
- guiding Datica and Propeller Health towards integrations that better fit workflow needs, and providing guidance on implementation patterns to make patient data more easily available in MyChart
- engaging with Datica, the hospital, and Epic in a manner that ensured success, including weekly meetings and daily Slack sessions with Datica team members
- whiteboarding the initial workflow ideas, translating HL7 messaging, and working as the project Sherpa to guide the complete integration process
Tracy explains that the Datica Managed Integration Services’ process and Olschesky’s expertise is why he wanted to partner with Datica. “I only have a limited amount of time in my day, so relying on Mark to deliver a thoughtful, high-quality, robust solution is key to our successful integrations going forward.”
“Any time you find a resource that understands Epic, like Mark and his team do, you are more likely to meet your desired project goals.”— Greg Tracy, Co-founder & CTO, Propeller Health
OPERATIONAL AND CLIENT-SIDE IMPACT
Propeller Health indicates that the Datica integration partnership did several things for their company:
- Sped up the process of integration, allowing the company to move more rapidly with their client
- Eliminated the need to build new infrastructure to support the integration
- Created a higher likelihood of success
“Any time you find a resource that understands Epic, like Mark and his team do, you are more likely to meet your desired project goals,” Tracy says. “Anyone that looks at Datica and how the company presents itself around HL7 messaging, HIPAA compliance, becoming HITRUST Certified, as well as how transparent the company is with sharing how the platform was built; that says it all.” Tracy, who says he never considered any other company for the integration piece, explains that the company has done a nice job of conveying its expertise. “Datica has a secure and trusted culture built around its platform; that has always impressed me.”
ABOUT PROPELLER HEALTH
Founded in 2010, Propeller is the leading provider of an FDA-cleared digital health platform that helps reduce the cost of care while delivering better quality of life for individuals with chronic respiratory disease. Propeller provides better engagement, communication, and more insightful and personalized care. Backed by Safeguard Scientifics, Social Capital, California HealthCare Foundation, Kapor Capital and other investors, Propeller has been used by patients with asthma or COPD in over 40 commercial programs across the US at major healthcare systems, payers, employers and other commercial partners. Company recognition includes TEDMED Innovation Showcase, White House Champion of Change, and Bluetooth Breakthrough Product awards. Visit propellerhealth.com to request more information.
Datica (formerly Catalyze) makes digital health in the cloud a reality by removing the risks that prevent its adoption. We turn HIPAA compliance on public infrastructure providers into a solved problem, and enable secure clinical data exchange between mission-critical digital health applications and EHR systems. Datica serves healthcare’s complete spectrum, from digital health startups and industry leaders to health systems across the nation. Hundreds of customers and partners trust Datica to ensure their clouds are HITRUST certified and data securely interoperable. For more information, visit datica.com.